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Senolytics: from pharmacological inhibitors to immunotherapies, a promising future for patients’ treatment
Abstract
The involvement of cellular senescence in the initiation and propagation of diseases is clearly characterized, making the elimination of senescent cells essential to treat age-related diseases. The development of senolytic drugs demonstrated that targeting these cells limits the deterioration of patients’ condition, by inducing apoptosis. Nevertheless, the first generations of senolytics which has been developed displayed their activities through specific mechanisms and demonstrated several limitations during clinical development. However, the rational to eliminate senescent cells remains evident, with the necessity to develop specific therapies in a context of diseases and tissues. The evolutions in the field of drug discovery open the way to a new generation of senolytic therapies, such as immunological approaches (CAR-T cells, Antibody-Drug Conjugated or vaccines), which require preliminary steps of research to identify markers specifically expressed on senescent cells, demonstrating promising specific effects. Currently, the preclinical development of these strategies appears more challenging to avoid strong side effects, but the expected results are commensurate with patients’ hopes for treatments. In this review, we highlight the fact that the classical senolytic approach based on drug repurposing display limited efficacy and probably reached its limits in term of clinical development. The recent development of more complex therapies and the extension of interest in the domain of senescence in different fields of research allow to extend the possibility to discover powerful therapies. The future of age-related diseases treatment is linked to the development of new approaches based on cell therapy or immunotherapy to offer the best treatment for patients.
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“However, the efficacy of D + Q and other senolytics has shown variability across models and contexts, with inconsistent effects on senescence markers and limited evidence of lifespan extension in more rigorous or genetically diverse preclinical settings38”
From Emerging strategies in senotherapeutics: from broad-spectrum senolysis to precision reprogramming (2026) · cites this paper as [38]
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“these agents exhibited notable drawbacks, such as dose-dependent thrombocytopenia, variable therapeutic efficacy, and the emergence of resistance mechanisms.”
From Emerging strategies in senotherapeutics: from broad-spectrum senolysis to precision reprogramming (2026) · cites this paper as [38]
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Citations
Cites
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“…more effective and allows to target more senescent cell types (compared to the use of each drug alone), by inhibiting the pro-survival pathways induced in senescent cells, notably in idiopathic pulmonary fi brosis (IPF) 10 – 12 , diabetes and chronic kidney disease 13 or Alzheimer ’ s disease 14 .”
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Senolytics in idiopathic pulmonary fibrosis: Results from a first-in-human, open-label, pilot study
Justice, J. N., Nambiar, A. M., Tchkonia, T., LeBrasseur, N. K., Pascual, R., Hashmi, S. K., Prata, L., Masternak, M. M., Kritchevsky, S. B., Musi, N., et al. (2019) · EBioMedicine · doi:10.1016/j.ebiom.2018.12.052 · Cited by 1,261
Cellular senescence and senolytics: the path to the clinic
Chaib, S., Tchkonia, T., & Kirkland, J. L. (2022) · Nature Medicine · doi:10.1038/s41591-022-01923-y · Cited by 1,134 · cited 1×
“Different senolytics have been developed in the antibody or small drug fi elds but nothing regarding senescent cells due to the lack of identi fi cation of speci fi c surface targets on these cells 51 .”
BackgroundSenolytic CAR T cells reverse senescence-associated pathologies
Amor, C., Feucht, J., Leibold, J., Ho, Y.-J., Zhu, C., Alonso-Curbelo, D., Mansilla-Soto, J., Boyer, J. A., Li, X., Giavridis, T., et al. (2020) · Nature · doi:10.1038/s41586-020-2403-9 · Cited by 1,098
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Cellular senescence: a key therapeutic target in aging and diseases
Zhang, L., Pitcher, L. E., Yousefzadeh, M. J., Niedernhofer, L. J., Robbins, P. D., & Zhu, Y. (2022) · Journal of Clinical Investigation · doi:10.1172/jci158450 · Cited by 631
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Cited by
Sorted by citations
The Impact of Immune System Aging on Infectious Diseases
Quiros-Roldan, E., Sottini, A., Natali, P. G., & Imberti, L. (2024) · Microorganisms · doi:10.3390/microorganisms12040775 · Cited by 133
“…demonstrated moderate efficacy when used in clinical trials, next-generation senolytics (CAR-T cells, antibody drug conjugates or vaccines) targeting specific proteins selectively expressed during senescence and, based on new technical developments, can pave the way for preclinical research [263].”
Emerging strategies in senotherapeutics: from broad-spectrum senolysis to precision reprogramming
Zhang, W., Song, S., Zhang, Y., Pan, Y., Hu, D., & Wang, Y. (2026) · npj Aging · doi:10.1038/s41514-026-00355-z · Cited by 6
Metadata
- Authors
- Lelarge, V., Capelle, R., Oger, F., Mathieu, T., & Le Calvé, B.
- Venue
- npj Aging
- Published
- 2024-02-06
- Volume
- 10
- Issue
- 1
- ISSN
- 2731-6068
- PMC
- PMC10847408
- Cited by
- 140
- References
- 18
- Language
- en
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